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HIPAA Notice of Privacy Practices - Kirkland Dental Excellence

HIPAA Notice of Privacy Practices

Effective Date: April 16th, 2026

This Notice explains how your health information may be used and disclosed and how you may access this information. Please read it carefully.

Kirkland Dental Excellence is committed to protecting your privacy. We are required by federal law (HIPAA) and by applicable Washington State laws to safeguard the confidentiality and security of your Protected Health Information (PHI), provide this Notice describing our legal duties and privacy practices, and inform you if a breach occurs involving your unsecured PHI.

We are obligated to follow the terms of this Notice while it remains in effect. We may modify or update this Notice as permitted by law. If changes are made, the revised version will be available in our office, and copies will be provided upon request.

How We May Use and Disclose Your Health Information

We may use or disclose your PHI for the following purposes:

  1. Treatment

We may use or share your PHI to provide, coordinate, or manage your dental care. This includes communication with specialists, dental laboratories, pharmacies, or other healthcare providers involved in treating you.

  1. Payment

Your PHI may be used for billing and payment-related tasks, including:

  • Submitting claims
  • Eligibility checks
  • Claims management
  • Collections activities
  1. Healthcare Operations

We may use your information to support the routine operations of our practice, including:

  • Quality assessment and improvement
  • Credentialing, staff training, and evaluation
  • Licensing, audits, and compliance activities
  • Internal administration and management

Other Uses and Disclosures Permitted or Required by Law

Individuals Involved in Your Care

Information may be shared with family members, caregivers, or others involved in your care as allowed by law or as authorized by you.

Disaster Relief

PHI may be disclosed to assist with disaster or emergency response efforts.

Public Health and Safety

We may disclose PHI to public health authorities for purposes such as:

  • Preventing or controlling disease
  • Reporting abuse or neglect
  • Reporting adverse drug reactions
  • Product recalls
  • Exposure notifications

Law Enforcement

PHI may be disclosed for law enforcement purposes when required by HIPAA or Washington State law.

Health Oversight

We may share PHI with oversight agencies conducting audits, inspections, or investigations.

Judicial or Administrative Proceedings

We may disclose PHI in response to subpoenas, court orders, or administrative requests as permitted by law.

Research

Limited PHI may be disclosed for approved research projects that include proper privacy safeguards.

Coroners, Medical Examiners, and Funeral Directors

We may provide PHI needed for these professionals to fulfill their duties.

National Security & Military

If you serve in the U.S. Armed Forces or are involved in national security functions, PHI may be disclosed as required.

Fundraising

We may contact you to support practice‑related fundraising activities. You may opt out at any time.

Uses Requiring Written Authorization

Certain uses of PHI require your written permission, including:

  • Psychotherapy notes (if applicable)
  • Marketing communications not related to your care
  • Sale of PHI

You may revoke your authorization at any time in writing.

Your Rights Regarding Your Health Information

  1. Right to Access

You may request to view or obtain copies of your PHI. Electronic copies are available when feasible. Reasonable, cost‑based fees may apply.

  1. Right to Request Restrictions

You may ask us to place limits on how your PHI is used or disclosed.

We are not required to agree, except when the restriction concerns a service you paid for fully out‑of‑pocket and you request that we not share that information with your insurer.

  1. Right to Request Confidential Communications

You may request to be contacted through alternative phone numbers, addresses, or other communication methods.

  1. Right to Amend

If you believe your PHI is inaccurate or incomplete, you may request an amendment. If a request is denied, we will provide a written explanation.

  1. Right to Accounting of Disclosures

You may request a list of certain disclosures made during the previous six years, except for those related to treatment, payment, healthcare operations, and other legally exempt categories.

  1. Right to Notification of Breach

You will be notified in writing if a breach occurs that compromises the privacy or security of your PHI.

  1. Right to Paper Copy

You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

State‑Specific Information: Washington

Washington State law generally aligns with HIPAA but includes enhanced protections for certain types of information. Washington places stricter confidentiality requirements on:

  • Mental health treatment records
  • Substance use disorder information
  • HIV/AIDS status
  • Sexually transmitted disease records
  • Genetic testing information

When Kirkland Dental Excellence handles any category protected under stronger Washington statutes, we will follow the stricter standard.

Questions, Requests, or Complaints

If you have questions, want to exercise your privacy rights, or wish to file a complaint, please contact:

Kirkland Dental Excellence – Privacy Officer

1619 Market St

Kirkland, WA 98033

Phone: (425) 827‑2003

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

We will not retaliate against you for filing a complaint.

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